Basturk Olca, Coban Ipek, Adsay N Volkan
Department of Pathology, New York University, New York, New York, USA.
Arch Pathol Lab Med. 2009 Mar;133(3):423-38. doi: 10.5858/133.3.423.
Cystic lesions of the pancreas are being recognized with increasing frequency and have become a more common finding in clinical practice because of the widespread use of advanced imaging modalities and the sharp drop in the mortality rate of pancreatic surgery. Consequently, in the past 2 decades, the nature of many cystic tumors in this organ has been better characterized, and significant developments have taken place in the classification and in our understanding of pancreatic cystic lesions.
To provide an overview of the current concepts in classification, differential diagnosis, and clinical/biologic behavior of pancreatic cystic tumors.
The authors' personal experience, based on institutional and consultation materials, combined with an analysis of the literature.
In contrast to solid tumors, most of which are invasive ductal adenocarcinomas with dismal prognosis, cystic lesions of the pancreas are often either benign or low-grade indolent neoplasia. However, those that are mucinous, namely, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, constitute an important category because they have well-established malignant potential, representing an adenoma-carcinoma sequence. Those that are nonmucinous such as serous tumors, congenital cysts, lymphoepithelial cysts, and squamoid cyst of pancreatic ducts have no malignant potential. Only rare nonmucinous cystic tumors that occur as a result of degenerative/necrotic changes in otherwise solid neoplasia, such as cystic ductal adenocarcinomas, cystic pancreatic endocrine neoplasia, and solid-pseudopapillary neoplasm, are also malignant and have variable degrees of aggressiveness.
胰腺囊性病变的发现频率日益增加，由于先进成像技术的广泛应用以及胰腺手术死亡率的急剧下降，胰腺囊性病变在临床实践中已成为更常见的发现。因此，在过去20年中，该器官中许多囊性肿瘤的性质得到了更好的描述，并且在胰腺囊性病变的分类及我们对其的认识方面取得了重大进展。
概述胰腺囊性肿瘤在分类、鉴别诊断及临床/生物学行为方面的当前概念。
作者基于机构资料和会诊材料的个人经验，并结合文献分析。
与大多数为预后不良的浸润性导管腺癌的实性肿瘤不同，胰腺囊性病变通常要么是良性的，要么是低度惰性肿瘤。然而，那些黏液性病变，即导管内乳头状黏液性肿瘤和黏液性囊性肿瘤，构成了一个重要类别，因为它们具有明确的恶性潜能，代表了腺瘤-癌序列。那些非黏液性病变，如浆液性肿瘤、先天性囊肿、淋巴上皮囊肿和胰腺导管鳞状样囊肿，没有恶性潜能。只有极少数因其他实性肿瘤发生退行性/坏死性改变而出现的非黏液性囊性肿瘤，如囊性导管腺癌、囊性胰腺内分泌肿瘤和实性假乳头状肿瘤，也是恶性的，且具有不同程度的侵袭性。
